叙事疗法对永久性肠造口患者病耻感影响的研究

目的 评价叙事疗法对永久性肠造口患者病耻感的影响。 方法 选取2018年4月—11月在某三级甲等医院胃肠外科、结直肠肛门外科行腹会阴联合直肠癌根治术的47例患者,通过一对一、面对面或视频通话的形式,对患者进行每周1次、每次30~45 min、共8次的叙事疗法;采用社会影响量表和造口适应量表评价干预前后的效果。 结果 出院前1 d、干预结束、干预结束后1个月,患者社会影响量表得分分别为（59.64±6.62）分、（53.87±8.78）分、（47.98±8.47）分,不同时间点病耻感差异有统计学意义（F=179.078,P<0.001）;造口适应量表得分分别为（40.49±7.13）分、（45.68±6.87）分、（46.70±7.11）分,不同时间点社会心理适应水平差异有统计学意义（校正后F=75.295,P<0.001）。 结论 叙事疗法有助于降低永久性肠造口患者的病耻感并提高其社会心理适应水平。     

糖尿病患者门诊注射胰岛素方案调整方法对比观察

[目的]观察门诊糖尿病患者注射胰岛素应用不同管理方法是否均安全、有效。[方法]选择我院内分泌科门诊就诊,86例新诊断的2型糖尿病患者,随机分为2组,一组管理方法,患者自己血糖监测,医生调整胰岛素剂量,自己注射胰岛素设为观察组;另一组管理方法,患者自己血糖监测,医生给出胰岛素用药方案原则后,自己调整胰岛素剂量,自己注射胰岛素设为对照组。针对不同管理方法对糖尿病患者的治疗疗效、达标时间及低血糖发生率进行比较。[结果]两组治疗效果相似,对照组达标时间较观察组稍长,但无统计学差异。对照组轻微低血糖发生率稍高于观察组,但两组无统计学差异。[结论]两种管理方法均安全有效。     

西门子SOMATOM Spirit双层螺旋CT准直器的维修调节方法

介绍一例西门子SOMATOM Spirit双层螺旋CT在运行中准直器故障,对维修中对准直器的维修调节方法进行总结。     

Experiences of Turkish Women with Breast Cancer During the Treatment Process and Facilitating Coping Factors

Background: Breast cancer is the most common type of cancer among women in Turkey and around theworld. Treatment adversely affects women’s physical, psychological, and social conditions. The purpose of thisstudy was to identify the experiences of Turkish women with breast cancer and the facilitating coping factorswhen they receive chemotherapy. Methods: A phenomenological approach was used to explain the experiencesand facilitating factors of breast cancer patients during the treatment period. Data were collected throughindividual semi-structured interviews. The sample comprised 11 women with breast cancer receiving treatment.Results: At the end of the interviews conducted with women with breast cancer, two main themes were identified:adjustment and facilitating coping factors. The adjustment main theme had two sub-themes: strains and coping.Women with breast cancer suffer physical and psychological strains as well as stress related to social and healthsystems. While coping with these situations, they receive social support, turn to spirituality and make new sensesof their lives. The facilitating coping factors main theme had four sub-themes: social support, disease-relatedfactors, treatment-related factors and relationships with nurses. It has been determined that women receivinggood social support, having undergone preventive breast surgery and/or getting attention and affection fromnurses can cope with breast cancer more easily. Conclusions: Women with breast cancer have difficulty in allareas of their lives in the course of the disease and during the treatment process. Therefore, nurses should provideholistic care, teaching patients how to cope with the new situation and supporting them spiritually. Since familysupport is very important in Turkish culture, patients’ relatives should be informed and supported at every stageof the treatment.     

Contribution of attachment insecurity to health-related quality of life in depressed patients

AIM: To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life (HRQoL) in patients diagnosed with adjustment disorder (AJD) with depressed mood.METHODS: Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance (ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package (SPSS Inc., Chicago, IL, United States).RESULTS: ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggest that depressive symptoms were more severe (F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer (F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQoL, accounting for 21.4% and 29.7% of the total variance, respectively [R² = 0.79; Adjusted R² = 0.77; F (5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.CONCLUSION: The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQoL outcome in AJD with depressed mood.     

Do I fit in? Psychosocial ramifications of low gender typicality in early adolescence

The current longitudinal study was designed to examine one of the possible underlying mechanisms that can help account for why low gender typicality (i.e., not feeling like a typical boy or girl) is related to subsequent psychosocial adjustment problems: peer victimization. Relying on a large (N = 5,991, 52% female), ethnically diverse U.S. sample, the results suggested that peer victimization at 7th grade partially accounts for associations between 7th grade gender typicality and 8th grade social anxiety, somatic complaints, and externalizing behavior, when controlling for earlier (e.g., 6th grade) levels of adjustment. Associations were similar across ethnic groups. Peer victimization mediated associations for boys and girls across all outcomes; however, girls showed stronger associations with somatic complaints and boys showed stronger associations with externalizing behavior. These results suggest that attempts to improve adjustment for youth feeling low gender typicality should focus in part on reducing peer victimization.     

Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review

ABSTRACT

The aim of this review was to examine studies describing the psychological stress and adjustment in pregnancy after an assisted reproductive technology (ART) treatment. A systematic search of the electronic databases was performed. This review considered only quantitative, primary studies in the English language, published during the period 2000–2014 and relevant to the objective. The population of interest was previously infertile pregnant women. Outcome variables were general anxiety, depressive symptoms, pregnancy-specific anxiety, quality of life, self-esteem, pregnancy attitudes and adjustment, and maternal-fetal attachment. Twenty studies met the inclusion and methodological criteria and were included in the review. The review revealed that compared to women who conceive naturally or to general norms, women who conceive after an in vitro fertilization treatment had greater pregnancy-specific anxiety, poorer quality of life, either the same or less depressive symptomatology, the same level of self-esteem, more positive attitudes toward pregnancy demands, and higher levels of maternal-fetal attachment. However, the evidence regarding the general anxiety levels in pregnancy after an ART treatment was inconclusive. Methodological limitations and differences across studies may explain the inconsistencies in their findings regarding the impact of ART. This review provides an insight into psychological reactions and adjustment in pregnancy after an ART treatment.